Introduction of a prescribing ward round to reduce prescribing errors on a paediatric intensive care unit

Aisling Walsh1, Rachelle Booth2, Kalindi Rajani2

  • 1Paediatric Intensive Care Unit, Great Ormond Street Hospital For Children NHS Foundation Trust, London, UK aislingwalsh@hotmail.com.

Insights

Implementing daily multidisciplinary prescribing rounds in a pediatric intensive care unit (PICU) significantly reduced medication prescribing errors and improved staff workflow, with 98% of staff supporting its continuation.

Area of Science:

  • Pediatric Intensive Care
  • Medication Safety
  • Healthcare Quality Improvement

Background:

  • Paediatric intensive care units (PICUs) face challenges with medication prescribing errors.
  • Active surveillance identified a mean of 1.66 total prescribing errors per occupied bed day in the PICU.

Purpose of the Study:

  • To reduce the number of prescribing errors in the PICU.
  • To improve unit workflow and decrease staff time spent on medication queries and prescribing.

Main Methods:

  • Introduction of a daily multidisciplinary prescribing round involving senior medical staff and pharmacists.
  • Active surveillance for prescribing errors before and after the intervention.

Main Results:

  • Total prescribing errors per bed day decreased from 1.66 (SD 0.18) to 1.19 (SD 0.13).
  • Clinical errors fell from 0.46 (SD 0.09) to 0.3 (SD 0.07), and non-clinical errors from 1.12 (SD 0.15) to 0.67 (SD 0.1).
  • 95% of staff reported reduced time on medication queries, and 90% of prescribers experienced fewer interruptions.

Conclusions:

  • A daily prescribing round with senior medical and pharmacist input effectively reduces medication prescribing errors in the PICU.
  • The intervention improved staff workflow and efficiency.
  • The prescribing round was highly accepted by staff, with 98% recommending its continuation.

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